The Financial Accounts Technician (OPECC) is located within the Office of Chief Operating Officer (COO), Consolidated Patient Account Center (CPAC), Revenue Operations, Office of Community Care, Veterans Health Administration, Department of Veterans Affairs, Las Vegas, NV.

Duties

***THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION*** The Financial Accounts Technician - OPECC provides a broad range of business services in support of VA medical center operations that includes Billing; Collections; Customer Service; Financial Reporting; Insurance Identification and Verification; Patient Access (Pre-registration, Pre-Certification, Scheduling, and Utilization Review); and Quality Assurance. Duties include, but may not be limited to the following: Serves as the Financial Accounts Technician (OPECC), responsible for the billing, accounts management, and insurance verification functions as they pertain to the ePharmacy program for all medical centers serviced by the CPAC. Acts as the liaison for the CPAC, Medical Center CPAC staff, Medical Center Pharmacy and CMOPs to resolve issues or problems with electronic and paper claim submission to maximize collections. Billing: Performs claims submission functions related to prescription drugs provided for beneficiaries with reimbursable prescription insurance. Utilizes various databases and reporting tools, responsible for running multiple reports; works those reports, in accordance with Internal Control audit and CPAC Billing functions. Provides expertise on claim submission actions, ensuring claims are submitted in various formats in compliance with specific requirements of the appropriate insurance carrier in order to improve collections. Provides expertise for pharmaceutical billing. Verifies benefits, policy information, pre-certification requirements, insurance company contact information and the effective dates of the insurance policy. Accounts Management: Performs collection functions of the Revenue Program Third Party insurance pharmacy reimbursements. Supports of debt collections, the technician reviews, researches and analyzes account receivable records by utilizing various databases. Trends various issues that arise with pharmacy insurance companies to maximize revenue. Ensures proper follow-up procedures are done through phone calls to the insurance companies, accessing insurance company's online data base and submitting letters to the insurance company and the Veteran. Determines payer requirements and comparing to potential billable encounters. Examines possible acquisition of retro-authorizations to ensure collections. Analyzes, plans, initiates, coordinates, and implements actions required to maximize collection of pharmacy receivables. Administrative: Assesses workload on a daily basis establishing priorities to facilitate the timely and appropriate completion of all assigned tasks. Solves complicated problems that arise with the electronic submission of pharmacy claims, including insurance verification, patient accounts, and data validation. Establishes goals and objectives for the program and accomplishes those goals, establishing strategic plans. Establishes monitoring and improvement systems. Establishes management information systems and develops resources needed. Assists in maintaining Standard Operating Procedures (SOPs) and training materials. Perform other duties as assigned. Work Schedule: Monday - Friday; 8:00am - 4:30pm Recruitment & Relocation Incentives: Not authorized Telework: VA supports the use of telework as a way to help attract and retain talented individuals in public service, increase worker productivity, and better prepare the agency to operate during emergencies. This position may be authorized for telework. Telework eligibility will be discussed during the interview process. Financial Disclosure Report: Not Required

Requirements

Qualifications

ENGLISH LANGUAGE PROFICIENCY: In accordance with 38 U.S.C. 7402(d), No person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. You must be proficient in basic written and spoken English in order to meet the requirements of this position. and SPECIALIZED EXPERIENCE: Applicants must have at least one (1) year of specialized experience that equipped them with the knowledge, skills, and abilities to successfully perform the duties of this position, and that is typically in or related to the work of this position. To be creditable, this experience must have been equivalent to at least the GS-5 level in the Federal service. Specialized experience includes performing health care support functions and operations for third-party accounts management, accounts receivables, billing, health information management, patient access compliance, insurance, and financial reporting; performing administrative work in collections; and preparing correspondence, memoranda, and written reports utilizing various computer software applications; understanding of drug and medication brand names, generic names, chemical names, and medical terminology to ensure appropriate pharmacy billing and follow-up activities in the revenue cycle; insurance payer agreements and numerous types of insurance policies and coverage to ensure appropriate pharmacy billing and follow-up activities in the revenue cycle: making determinations on best course of action regarding billing and accounts management to affect maximum recovery; providing billing, accounts management and insurance verification functions; submitting claims; reviewing, researching, and analyzing account receivable records by utilizing various databases; running multiple reports; and performing follow-up procedures through phone calls, on-line data bases and letters to insurance companies and customers. You will be rated on the following Competencies as part of the assessment questionnaire for this position: Analytical ThinkingOrganizational Performance AnalysisPrinciples of FinanceTechnical Competence IMPORTANT: A full year of work is considered to be 35-40 hours of work per week. All experience listed on your resume must include the month and year start/end dates. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Physical Requirements: The work is primarily sedentary, although some slight physical effort may be required. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

There is no educational substitution at this grade level.

NOTE: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: Recognition of Foreign Qualifications | International Affairs Office (ed.gov).

Contacts

• Address VA WCPAC Las Vegas 736 1085 Palm Airport DR Las Vegas, NV 89119 US
• Name: VHA National Recruitment Center
• Phone: (844)456-5208
• Email: [email protected]